Eye Care Center Eye Care Center at the Southern California at the Southern California College of Optometry College of Optometry MaryAnn Walls Low MaryAnn Walls Low Vision Center Vision Center Dr. Becky Kammer, Dr. Becky Kammer, Chief Chief 714-449-7415 714-449-7415 [email protected][email protected]
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Eye Care Center at the Southern California College of Optometry MaryAnn Walls Low Vision Center Dr. Becky Kammer, Chief [email protected].
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Eye Care CenterEye Care Centerat the Southern California College of at the Southern California College of
Patients may be blind or just partially Patients may be blind or just partially sighted (visually impaired) 20/70 or worse sighted (visually impaired) 20/70 or worse in better eyein better eye
Legally Blind is 20/200 or worse with best Legally Blind is 20/200 or worse with best correction on correction on
What can Rehabilitative Optometry What can Rehabilitative Optometry do to help?do to help?
Help patients see to readHelp patients see to read
Help patients see to driveHelp patients see to drive
Help patients meet specific vision goalsHelp patients meet specific vision goals
Main Rehabilitation GoalMain Rehabilitation Goal
Improve independence Improve independence and quality of lifeand quality of life
How does the exam flow?How does the exam flow?
Patient’s come for at least 2-3 visits where Patient’s come for at least 2-3 visits where a full eye exam is given and then devices a full eye exam is given and then devices are introduced to meet goalsare introduced to meet goals
First Visit: Team is introduced to patientFirst Visit: Team is introduced to patient– Occupational therapistOccupational therapist– Student doctorStudent doctor– Faculty professor Faculty professor
OT will schedule a home evaluation before OT will schedule a home evaluation before patient returns for second visit.patient returns for second visit.
Second VisitSecond Visit
OT summarizes their home visit for Dr. OT summarizes their home visit for Dr. and the second optometric visit is planned and the second optometric visit is planned for the patient.for the patient.
More visual goals are evaluated, devices More visual goals are evaluated, devices are orderedare ordered
Possibly more training visits with OT are Possibly more training visits with OT are scheduled in the meantimescheduled in the meantime
Dispensing VisitDispensing Visit
Patient’s glasses or devices are given to Patient’s glasses or devices are given to patient and basic training in office is patient and basic training in office is providedprovided
OT schedules 2-4 more home visits to OT schedules 2-4 more home visits to make sure patient uses device correctly make sure patient uses device correctly and is using residual vision correctly and is using residual vision correctly (eccentric viewing training if needed)(eccentric viewing training if needed)
OT reports back to Dr. for follow upOT reports back to Dr. for follow up
EXAM COMPONENTSEXAM COMPONENTSCase historyCase history
Summarize to obtain basic goalsSummarize to obtain basic goals– Sustained Near: Sustained Near: Reading continuous textReading continuous text– Spotting Near: Spotting Near: Seeing bills, shoppingSeeing bills, shopping– Sustained Distance: Sustained Distance: Watching TVWatching TV– Spotting Distance: Spotting Distance: Driving, seeing signsDriving, seeing signs – Illumination and Glare: Illumination and Glare: often need often need
enhanced contrast indoor, need better enhanced contrast indoor, need better lighting indoorlighting indoor
Testing is critical for determining if Testing is critical for determining if low contrast objects can be seen in low contrast objects can be seen in dim lightingdim lightingPoor contrast sensitivity may slow Poor contrast sensitivity may slow down reading or cause problems down reading or cause problems driving at night…driving at night…
– Depth perception up close (3D)Depth perception up close (3D)Many nystagmus patients have no Many nystagmus patients have no depth perception (or true depth perception (or true binocularity)binocularity)
– Most Low Vision patients are Most Low Vision patients are functionally monocularfunctionally monocular
EXAM COMPONENTS EXAM COMPONENTS Calculations to determine the Calculations to determine the best type of magnification or best type of magnification or
modificationsmodifications
EXAM COMPONENTS EXAM COMPONENTS A Few Treatment optionsA Few Treatment options
Spectacle plane – high plus/microscopeSpectacle plane – high plus/microscope
Loupe – Hand magnifier, stand Loupe – Hand magnifier, stand magnifier, head mountedmagnifier, head mounted
TelescopesTelescopes
Electronic devicesElectronic devices
Filters/lightingFilters/lighting
Glare TreatmentGlare Treatment
Various colored Various colored filters (lens tints)filters (lens tints)
Relative Size Devices:Relative Size Devices: Large Print Large Print BooksBooksPosture and Positioning Devices: Posture and Positioning Devices: Lap Lap boards boards Writing DevicesWriting Devices:Felt tip pens:Felt tip pensMedical Devices: Medical Devices: Talking glucometers Talking glucometers Mobility DevicesMobility Devices: Cane, Dog guide: Cane, Dog guideSensory Substitution Devices: Sensory Substitution Devices: Talking Talking clocksclocks
ReferralsReferrals
Orientation and mobilityOrientation and mobility
Visual impairment instructor – Visual impairment instructor – independent living skillsindependent living skills
Department of RehabilitationDepartment of Rehabilitation
Support Groups/counselingSupport Groups/counseling
Braille Institute for ILS classesBraille Institute for ILS classes
What’s new in LV?What’s new in LV?
– Computer technology with adaptive softwareComputer technology with adaptive software– Volunteer at ECC provides one-on-one Volunteer at ECC provides one-on-one
computer appointments for low vision patientscomputer appointments for low vision patients
What’s on the horizon for LV?What’s on the horizon for LV?
Blind Art Exhibit in September 05Blind Art Exhibit in September 05
ResearchResearch– SCCO is now part of a progressive group that is SCCO is now part of a progressive group that is
attempting to initiate clinical trials in the U.S.attempting to initiate clinical trials in the U.S.– Completion of a small multi-center study with Completion of a small multi-center study with